A Qualitative Study of International Student Stresses and Mental Health during the COVID-19 Pandemic

Xiaoqiao Zhang, PhD

Massachusetts General Hospital
A Qualitative Study of International Student Stresses and Mental Health during the COVID-19 Pandemic

Scientific Abstract


Background: The COVID-19 pandemic has exacerbated existing stressors while adding new difficulties for international students, particularly those of East Asian descent. This qualitative study presents some of the key experiences of international students during this period as well as anticipated mental health concerns and help-seeking among international students.

Methods: Semi-structured interviews were conducted with a total of 22 students from 11 countries and 17 institutions recruited from a large national longitudinal Internet-delivered study of over 1,300 participates that focus on understanding the physical and emotional wellbeing of young adults during the COVID-19 pandemic. All interviews were recorded and transcribed verbatim by the first author and trained student research assistants. Thematic analysis was deployed to analyze the results.

Results: Although many of the stressful experiences described in the study were not unique to international students during the pandemic, international students have been forced to cope with additional unique stressors that are likely to further exacerbate their underlying propensity toward mental health problems. Four main such stressors were identified: (1) Uncertainty regarding legal status; (2) Fears regarding xenophobia; (3) Limited understanding by educators and educational support staff regarding the unique legal, financial, and policy concerns of international student; (4) Concerns about sense of belonging and cultural identity. Resilience- promoting factors included support from friends, institutions, and the local community.

Conclusions: To support international students during the pandemic and beyond, practitioners should explore strategies and opportunities to increase engagement with international students, through (1) gaining basic knowledge regarding visa policies and regulations, including knowing what resources to offer to students, (2) creating shared affinity spaces in which issues of racial and cultural identity and belonging can be discussed and processed, (3) increase psychoeducation targeted toward international students, and (4) increase practitioners cultural competency.

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research Areas


Xiaoqiao Zhang, PhD, Ga Tin Fifi Wong, BA, Cindy H. Liu, PhD, Hyeouk Chris Hahm, PhD, Justin A. Chen, MD, MPH